All-epiphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients

Lawrence, J. Todd R.; Bowers, Andrea L.; Belding, Jonathan; Cody, Stephanie R.; Ganley, Theodore J.

doi:10.1007/s11999-010-1255-2

Cited by 152 publications

(143 citation statements)

References 39 publications

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“…Milewski et al [57] proposed a treatment algorithm based on bone age. This algorithm recommends the MicheliKocher technique [58] for patients with a skeletal age of 6, the modified Anderson technique for skeletal age of 8, the GanleyLawrence All-Epiphyseal technique [59] (Fig. 3) for skeletal age of 10, a hybrid technique for skeletal age of 12, and a Fig.…”

Section: Physis Statusmentioning

confidence: 99%

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Pediatric ACL injuries: evaluation and management

Mall¹,

Paletta

2013

Curr Rev Musculoskelet Med

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The anterior cruciate ligament (ACL) is a stabilizing structure to both anterior translation of the tibia with respect to the femur as well as rotation of the knee joint. Children and adolescents are susceptible to these injuries, and there are some who believe the incidence of ACL injuries in this population is increasing due to year round single sport participation. Pediatric ACL injuries are typically seen in several forms: tibial avulsion fractures, partial ACL tears, and full thickness ligament tears. There were and still are some who feel that ACL injuries should be treated non-operatively in the pediatric and adolescent population; however, recent literature refutes this notion. Several factors must be considered during pediatric and adolescent ACL reconstruction, each of which will be examined in this manuscript, including: status of the physis, reconstruction technique, and graft source.

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Section: Physis Statusmentioning

confidence: 99%

“…The knee is brought into extension and the graft tensioned and secured in the femur with an interference screw. (Adapted from [59], with permission.) transphyseal technique for those of skeletal age 14 or older.…”

Section: Physis Statusmentioning

confidence: 99%

Pediatric ACL injuries: evaluation and management

Mall¹,

Paletta

2013

Curr Rev Musculoskelet Med

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“…ACL reconstruction in skeletally immature pediatric patients, via both transphyseal and physeal-sparing techniques, reportedly restores knee stability and returns 88% to 100% of patients to their preinjury levels of activity [4,[15][16][17][18]. Similar average levels of return to activity are present for primary ACL reconstruction in adults [2,27].…”

Section: Introductionmentioning

confidence: 99%

Revision ACL Reconstruction in Skeletally Mature Athletes Younger Than 18 Years

Reinhardt

Hammoud

Bowers

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Young, active, skeletally mature patients have higher failure rates after various surgical procedures, including stabilization for shoulder instability and primary ACL reconstruction. It is unclear whether young, active, skeletally mature patients share similarly high failure rates after revision ACL reconstruction. Questions/purposes We therefore determined whether revision ACL reconstruction restores knee stability and allows young (younger than 18 years), active, skeletally mature patients to return to preinjury activity levels. Patients and MethodsWe retrospectively identified 36 patients who had an initial ACL reconstruction between the ages of 12 and 17 years (mean, 15.4 years) and subsequent revision between the ages of 13 and 18 years (mean, 16.9 years); of these, 2-year followup was available for 21 (75%). Mechanisms of primary graft failure included traumatic rerupture (23 noncontact, seven contact), persistent instability (five), and infection (one). One patient had open physes at the time of revision. All revisions were single-stage transosseous reconstructions. The minimum followup was 24 months (mean, 36 months; range, 24-63 months).

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“…Extra-articular procedures might have a role in the treatment of young patients, but the results are not good and not isometric [14]. All epiphyseal reconstructions can be a good option in Tanner 1 patients with important instability, but, to our knowledge, only three cases have been presented [15].…”

Section: Introductionmentioning

confidence: 89%

Anterior cruciate ligament recostruction with bone-patellar tendon-bone autograft in Tanner 3 stage patients with open physes

Memeo

Pedretti

Miola

et al. 2012

Journal of Pediatric Orthopaedics B

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Ten skeletally immature patients were treated with an arthroscopic-assisted anterior cruciate ligament reconstruction with bone-patellar tendon bone autograft (compass, 50-558; holes, 7-9 mm). Radiological assessments (standard radiograph), Orthopä dische Arbeitsgruppe Knie (OAK) score and KT 1000, were conducted on all patients, 1 year after surgery. Skeletal maturity had been reached by all patients and no complications were observed. All patients returned to their preinjury sport level. Drilling more vertical tunnels when bone-tendon-bone autograft was chosen to avoid partial epiphysiodesis and offers good functional and isometric results.

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All-epiphyseal Anterior Cruciate Ligament Reconstruction in Skeletally Immature Patients

Abstract: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Cited by 152 publications

References 39 publications

Pediatric ACL injuries: evaluation and management

Pediatric ACL injuries: evaluation and management

Revision ACL Reconstruction in Skeletally Mature Athletes Younger Than 18 Years

Anterior cruciate ligament recostruction with bone-patellar tendon-bone autograft in Tanner 3 stage patients with open physes

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